Not patients’ fault if antibiotics have lost power

Fears over antibiotic usage leading to lethal infections will be discussed at G8 meeting Rex Features

A friend of mine, frustrated at being forever single, used to joke about how she would have courses of antibiotics that lasted longer than her relationships.

Putting aside what this says about being a thirtysomething woman in London, it shows how commonplace it has become for a quick seven-day prescription from our GP to cure everything from a sore throat to a chest infection.

We are awash with antibiotics. GPs have been over-prescribing them, reducing our immunity to deadly bacteria, which have become increasingly resistant to drugs.

This problem is so serious that last month, Dame Sally Davies, the chief medical officer, likened the threat from antibiotic-resistant infection to climate change and terrorism. Now the Prime Minister has launched a review into why no new antibiotics have been developed in the past 25 years.

This is all very frightening to patients, particularly those whose lives have been saved by antibiotics. When David Cameron talks about medicine returning to the “dark ages” if nothing is done about increasing resistance, he means women dying from what are normally routine, treatable infections after childbirth, or people being killed as a result of a single scratch. Antibiotics are the treatments we take for granted, and that is the core of the problem.

So who is to blame for this ticking time bomb, as Dame Sally called it? When the Prime Minister’s review was announced yesterday, there was a rush to point the finger at patients. A woman representing the Royal College of GPs was on the radio suggesting that patients are in part to blame because they expect a course of antibiotics from their doctor. Theodore Dalrymple, writing in The Times yesterday, said GPs had over-prescribed for fear of litigation from patients who become seriously ill.

'Six of the greatest challenges facing humanity': Which deserves £10m in prize money?

'Six of the greatest challenges facing humanity': Which deserves £10m in prize money?

1/6
Dementia: How can we help people with dementia live independently for longer?

"It is estimated that 135 million people worldwide will have dementia by 2050, which will mean a greater personal and financial cost to society. With no existing cure, there is a need to find ways to support a person’s dignity, physical and emotional wellbeing. The challenge is to develop intelligent, affordable integrated technologies that revolutionise care for people with dementia, enabling them to live independent lives." - Longitude Prize 2014

2/6
Paralysis: How can we restore movement to those with paralysis?

"In the UK, a person is paralysed every eight hours. Paralysis can emerge from a number of different injuries, conditions and disorders and the effects can be devastating. Every day can be demanding when mobility, bowel control, sexual function and respiration are lost or impaired. The challenge is to invent a solution that gives paralysed people close to the same freedom of movement that most of us enjoy." - Longitude Prize 2014

3/6
Water: How can we ensure everyone can have access to safe and clean water?

"Water is becoming an increasingly scarce resource. 44 per cent of the world’s population and 28 per cent of the world’s agriculture are in regions of the world where water is scarce. The challenge is to alleviate the growing pressure on the planet’s fresh water by creating a cheap, environmentally sustainable desalination technology." - Longitude Prize 2014

4/6
Food: How can we ensure everyone has nutritious, sustainable food?

"One in eight people worldwide do not get enough food to live a healthy and fulfilled life. With a growing population and limited resources, providing everybody with nutritious, sustainable food is one of the biggest global problems ever faced. The challenge is to invent the next big food innovation, helping to ensure a future where everyone has enough nutritious, affordable and environmentally sustainable food." - Longitude Prize 2014

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Antibiotics: How can we prevent the rise of resistance to antibiotics?

"The development of antibiotics has added an average of 20 years to our life. Yet the rise of antimicrobial resistance is threatening to make them ineffective. This poses a significant future risk as common infections become untreatable. The challenge is to create a cost-effective, accurate, rapid, and easy-to-use test for bacterial infections that will allow health professionals worldwide to administer the right antibiotics at the right time." - Longitude Prize 2014

6/6
Flight: How can we fly without damaging the environment?

"If aircraft carbon emissions continue to rise they could contribute up to 15 per cent of global warming from human activities within 50 years. This needs to be addressed in order to slow down climate change and its detrimental effects on the planet. The challenge is to design and build an aeroplane that is as close to zero-carbon as possible and capable of flying from London to Edinburgh, at comparable speed to today’s aircraft." - Longitude Prize 2014

There are two issues here, it seems: one is that patients can under-dose themselves by failing to finish the course, which allows bacteria to build up more resistance. For that, we patients must shoulder some of the blame. Because antibiotics can make us better within a day or two, it is easy to stop taking the tablets for the full course.

Yet this impending disaster for humans cannot just be laid at the door of patients. To suggest that we “expect” to be treated with antibiotics is just another buck-passing exercise that the medical profession is so fond of.

Just as GPs accuse patients of putting pressure on primary care when they are the ones who refuse to see us in evenings and at weekends, so too are they trying to blame us for the antibiotic crisis that has been, largely, in their control.

It is GPs, not patients, who have been dishing out antibiotics at the first sound of a cough or sight of a white spot on the tonsils. In the past few years there has been more awareness, on the part of both patients and doctors, of the resistance problem. But antibiotics have continued to be handed out like sweets.

Is it any wonder when doctors seem to want to get rid of us as soon as possible from their consulting rooms? Appointments are supposed to be in 15-minute slots, but you are lucky if you get as much as five minutes. The problem of over-prescription is not about fear of litigation but merely part of a wider culture of patients being treated more like items on a supermarket checkout belt than as sick people needing treatment. And this culture, of course, is down to the dwindling amount of money and time there is to go around in the NHS.

There is also, as ever, a serious case to answer from Big Pharma. Cameron’s review, to be chaired by the economist Jim O’Neill, is about market failure, and why scientists and drug companies have not developed new antibiotics since the late 1980s. To suggest patients are at the heart of this crisis is simply a joke.

Where better to give birth than Primark?

As many heavily pregnant women will know, if you go into labour while shopping at John Lewis the company gives you free vouchers to spend on your new baby. At least this was the case in 2010, when, several days overdue, I would hobble around their maternity department hoping for my waters to break.

It never happened (in the end I went into labour in our local pub, a pretty useless place for waters to break if ever there was one). But I thought of this when I read about the woman who gave birth on a busy shopping street outside Primark in Birmingham this week.

Paramedics and passers-by helped her give birth to a girl as she was shielded by blankets. The first thing I thought was, I wonder if she had been hoping for some Primark freebies? And the second thing I thought was, how unlucky to be just outside the shop. I hope Primark does the decent thing and sends her some vouchers for the free publicity.